Validation of Catquest-9SF-A Visual Disability Instrument to Evaluate Patient Function after Corneal Transplantation

Margareta Claesson*, W. John Armitage, Berit Byström, Per Montan, Branka Samolov, Ulf Stenvi, Mats Lundström

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

6 Citations (Scopus)
312 Downloads (Pure)


Purpose: Catquest-9SF is a 9-item visual disability questionnaire developed for evaluating patient-reported outcome measures after cataract surgery. The aim of this study was to use Rasch analysis to determine the responsiveness of Catquest-9SF for corneal transplant patients. Methods: Patients who underwent corneal transplantation primarily to improve vision were included. One group (n = 199) completed the Catquest-9SF questionnaire before corneal transplantation and a second independent group (n = 199) completed the questionnaire 2 years after surgery. All patients were recorded in the Swedish Cornea Registry, which provided clinical and demographic data for the study. Winsteps software v.3.91.0 (, Beaverton, OR) was used to assess the fit of the Catquest-9SF data to the Rasch model. Results: Rasch analysis showed that Catquest-9SF applied to corneal transplant patients was unidimensional (infit range, 0.73-1.32; outfit range, 0.81-1.35), and therefore, measured a single underlying construct (visual disability). The Rasch model explained 68.5% of raw variance. The response categories of the 9-item questionnaire were ordered, and the category thresholds were well defined. Item difficulty matched the level of patients' ability (0.36 logit difference between the means). Precision in terms of person separation (3.09) and person reliability (0.91) was good. Differential item functioning was notable for only 1 item (satisfaction with vision), which had a differential item functioning contrast of 1.08 logit. Conclusions: Rasch analysis showed that Catquest-9SF is a valid instrument for measuring visual disability in patients who have undergone corneal transplantation primarily to improve vision.

Original languageEnglish
Pages (from-to)1083-1088
Number of pages6
Issue number9
Publication statusPublished - 1 Sep 2017


  • Catquest-9SF validation
  • Corneal Transplantation
  • patient-reported outcome measures


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